Motor and somatosensory evoked potentials in tuberculous meningitis: a clinico-radiological correlation

Citation
J. Kalita et Uk. Misra, Motor and somatosensory evoked potentials in tuberculous meningitis: a clinico-radiological correlation, ACT NEUR SC, 99(4), 1999, pp. 225-231
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Neurology,"Neurosciences & Behavoir
Journal title
ACTA NEUROLOGICA SCANDINAVICA
ISSN journal
0001-6314 → ACNP
Volume
99
Issue
4
Year of publication
1999
Pages
225 - 231
Database
ISI
SICI code
0001-6314(199904)99:4<225:MASEPI>2.0.ZU;2-0
Abstract
Objective - The sensory and motor functions in severe tuberculous meningiti s (TBM) may be difficult to assess clinically and may be helped by evoked p otential studies. Lack of motor and somatosensory evoked potential studies in TBM prompted the present study. Methods - All the patients with TBM unde rwent detailed neurological evaluation and cranial CT scan study. Motor and somatosensory evoked potentials to both upper and lower limbs were carried out bilaterally. The outcome was defined on the basis of 3 month Barthel I ndex (BI) score into good (BI greater than or equal to 12) and poor (BI<12) . Results - Forty-one highly probable patients with TBM whose ages ranged b etween 8 and 64 years and 14 of whom were females were included in this stu dy. Twenty-three patients were in stage III (meningitis, neurological signs and altered sensorium), 12 in stage II (meningitis with neurological sign) and the remaining patients were in stage I (meningitis only). Cranial CT s can was carried out in all and MRI in 18 patients. On CT scan hydrocephalus was present in 21, infarction in 14 and tuberculoma in 4 patients. Motor e voked potential (MEP) was abnormal in 18 patients (36 limbs) and SEP in 9 p atients (23 limbs). Upper limb central motor conduction time to abductor di giti minimi (CMCT-ADM) was abnormal in 15 and that to tibialis anterior (TA ) in 21 limbs. CMCT abnormality was lateralized in 6 and only upper or lowe r limbs were involved in 11 patients. The SEP abnormalities were lateralize d in 2 patients and only upper or lower limbs were involved in 3. The MEP c hanges correlated with stage of TBM and outcome whereas SEP with outcome on ly. Conclusion - Motor and somatosensory evoked potentials may be helpful i n objective documentation of respective motor and sensory functions in TBM patients with altered sensorium.